Organization
KENNEWICK GENERAL HOSITAL
Active
Other names
The Pharmacy at Trios Southridge
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PORTER (PHCY MANAGER)
(509) 221-7351
Entity
Organization
Contact information
Practice address
521 N YOUNG ST, KENNEWICK, WA 99336-7806
(509) 221-6150
(509) 221-6151
Mailing address
3730 PLAZA WAY, KENNEWICK, WA 99338-2718
(509) 221-6150
(509) 221-6151
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF000056883
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2107413
PK
—
05
—
6025795
—
WA
Enumeration date
04/09/2007
Last updated
09/14/2016
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